Chief Physician of the Macao Union Medical Center, Dr. Cao Qingdong (fourth from right), and Attending Physician of the Conde de São Januário General Hospital, Dr. Fan Sai Hou (third from left), work together on the surgery.
With the growing expertise of the thoracic surgery team, The Islands Healthcare Complex – Macao Medical Center of Peking Union Medical College Hospital (hereinafter referred to as “Macao Union Medical Center”) has successfully conducted over ten minimally invasive thoracic surgeries for local patients in the past few months, with the assistance of the da Vinci surgical robot, through a collaborative referral mechanism with the Conde de São Januário General Hospital. Currently, the Macao Union Medical Center has the comprehensive strength to routinely conduct various complex thoracic surgeries, including lung cancer, esophageal cancer, and mediastinal tumors.
Among these cases, one notably complex case involved an older adult patient suffering from a giant 8-centimeter lung tumor and a persistent issue with a large esophageal diverticulum. Despite undergoing neoadjuvant chemoimmunotherapy, the patient showed no significant reduction in tumor size. Therefore, a multidisciplinary team comprising Macao Union Medical Center’s experts in thoracic surgery, oncology, radiology, anesthesiology, critical care medicine, nutrition, rehabilitation, and the nursing team formulated a treatment plan involving da Vinci robot-assisted thoracoscopic radical resection of the right upper lung cancer and bronchoplasty. Dr. Cao Qingdong, chief physician of cardiothoracic surgery at the Macao Union Medical Center, performed the surgery, assisted by Dr. Fan Sai Hou, attending physician of cardiothoracic surgery at the Conde de São Januário General Hospital. With the robotic arms manipulated by the surgeons, the 8-centimeter tumor was completely resected through only three small chest incisions in the patient’s chest wall, and a thorough lymph node dissection and a right main bronchoplasty were successfully executed, entirely avoiding the need for a thoracotomy. After surgery, the patient recovered well, was able to walk on the first day, reported very little pain, and was discharged from the hospital.
Compared with the significant surgical trauma of traditional open-chest surgery, robot-assisted thoracoscopic surgery offers unparalleled advantages in terms of minimally invasive procedures. This approach allows for a more thorough lymph node dissection than conventional thoracoscopic surgery and greatly enhances surgical safety.
Another case involved a second surgery for an older adult patient. The local anatomy of the lesion site was complex, and the condition had significantly relapsed in the past six months, escalating the complexity and risk associated with the second surgery. The Macao Union Medical Center implemented a preoperative multidisciplinary consultation mechanism, bringing together experts including thoracic surgery, general surgery, gastroenterology, radiology, anesthesiology, critical care medicine, nutrition, rehabilitation, and the nursing team. Together, they formulated an innovative “combined dual-endoscopy approach” that eliminates the need for open-chest surgery. The surgery successfully removed the esophageal lesion and completed the esophageal reconstruction using a gastric pull-up with cervical anastomosis. The patient was promptly transferred to the ICU ward post-surgery, where the intensive care team from the Macao Union Medical Center delivered meticulous, one-on-one circulatory and respiratory management, ensuring a stable perioperative period.
The collaboration among the three parties ensures the goal of “Treating Major Diseases in Macao”
The Macao Union Medical Center stated that through regular exchanges and two-way referral cooperation mechanisms with the Conde de São Januário General Hospital, a large number of patients waiting for elective thoracic surgery have been successfully diverted. This not only demonstrates a high degree of medical synergy but also significantly reduces patients’ waiting time, underscoring the synergistic advantages of Macao’s medical resources.
In addition, the Macao Union Medical Center maintains close communication with Peking Union Medical College Hospital (PUMCH). PUMCH Experts from various disciplines can participate in multidisciplinary discussions through remote consultations to develop individualized, safe, and forward-looking treatment plans for complex cases. Through a comprehensive management model of “deep involvement of PUMCH experts, precise preoperative multidisciplinary decision-making, and post-surgery intensive care and nursing support,” and the assistance of top-notch equipment such as the da Vinci surgical robot and other world-class assistive tools, the most complex procedures for precise resection and reconstruction can be completed with minimal trauma.
In the future, the Macao Union Medical Center will further strengthen its collaboration with PUMCH and the Conde de São Januário General Hospital. This collaboration aims to offer treatment at international standards for complex chest diseases in Macao, providing more medical options, and actively realizing the goal of “Treating Major Diseases in Macao”.
